Viral rashes mimicking drug reaction with eosinophilia and systemic symptoms syndrome in children after β-lactams intake: a diagnostic challenge

Conclusion:  A rapid, correct diagnosis of such DRESS-like rashes during viral infections allows more appropriate management and avoids unnecessary, life-long exclusion of useful and effective antibiotics because of a falsely “amoxicillin-allergy” labelling.What is Known:• Viral infections are common causes of skin rashes in children during antibiotic intake and may require differential diagnosis with drug reactions.• Early-onset DRESS syndrome is usually induced by antibiotics and appears ≤15 days after drug intake.What is New:• Prominent midface edema, maculopapular rash, and mild-to-moderate systemic symptoms may appear in children during viral illnesses treated with amoxicillin few days after drug intake, and may require differential diagnosis with early-onset DRESS.• In such cases, absence of eosinophilia, low (2–3) RegiSCAR score, confirmation of viral etiology, and a rapid resolution of the rash (2–5 days) might help to rule out DRESS; conversely, at an early stage, the presence of eosinophilia should suggest a diagnosis of DRESS.
Source: European Journal of Pediatrics - Category: Pediatrics Source Type: research